scubanurse

Crazy world... this reply just showed up in my inbox. How is everyone holding up?

Dang ruff! I'm so sorry to hear that!

Damn. How is everyone? Hanging in there otherwise?

I wear an apple watch in the ER and a g-shock when I'm in the field. I have worn the apple watch a few times in the field but it wasn't the best option. In the ER I love my apple watch because i have a stop watch easily accessible and I am not distracted by my phone in patient rooms. In the field I just want something durable that can withstand me smashing it against concrete and I can dunk in bleach when I get blood on it.

Suffered a brutal assault while an ER nurse, left me with PTSD that I am still struggling with.

That's just awful, what a huge loss. Please pass along an address we can send cards to.

Welcome! Lots of seasoned folks here if you have any questions

I'm sorry my friend. Colorado lost 3 officers one right after another and it has devastated us. This is all just too much and it hurts.

Welcome! Love working with the RRT's! I'm an ER/Trauma nurse and always fascinated by the amount of knowledge you guys have, very valuable asset to the community.

I took a small break this fall to focus on family and school and work and now that I have a minute, I'm back! good to see some old faces pop up this fall. Sorry I've been gone, working 60 hrs a week and school has killed me. I was talking about you just the other week with one of my doc friends. He's gone to CAP lab with some of his guys and said he knew you...

I took a hiatus from social media while focusing on school this fall, sorry to have dropped off the face. I'd love to meet up and obviously Colorado Springs would be the closest, but I can try and make other things work as well. Sorry Ruff! Katie

I am so sorry my friend. I wish there was more I could do/say, you guys have been going through a lot. Please let us know if there's any gofundme or anything like that set up. I'll keep you guys in my prayers and thoughts.

thanks for posting the pic ruff!!

You're going to be bagging one way or another unless you carry vents on your 911 ambulances. I understand the concerns with the half life of roc, but it is the safer drug in cases where ICP is a concern. Mannitol is great for these but I don't know many services that carry it. Another thing in addition to elevating the head of the bed, is throwing a c-collar on these guys to maintain neutral alignment. Small things like that can add up and help save brain tissue. This unfortunate patient suffered both a subdural and intraparenchymal hemorrhage. Our working theory was that she had been using some herbs for her "heart condition" and they were either ineffective or made the problem worse. At some point she must have gotten up to vomit (probably from the intraparenchymal bleed and rising ICP) and hit her head on the floor. She was rushed to the OR urgently for a craniotomy. I will try and grab to post-surgical images when I'm at work next.

E-mailed them to you ruff... can't seem to get them to upload here.

This is a fun case and I have lots of pictures of her CT's and further management in the ED if anyone is interested.

Dispatched to a nice single family home, you are greeted at the door by the niece of the patient reporting her Aunt woke up and attempted to go to the bathroom but was unable to ambulate. Reported nausea and vomiting x 3 hrs PTA and took an unknown Chinese herb to aid in nausea. PT recently flew in from China for a two month long visit. NKDA No meds No know hx, niece reports possible heart trouble. initial VS: 276/134 HR 80 RR 9 irregular BGL 144 O2 76%RA what's next?

check is orientation with the usual questions, dig deeper into history, stroke scale, meds/illicit drugs, ETOH?

Worst case scenario...intubate them in the field and transport to local ED for a narcan drip.

Welcome back!

Dobutamine will help support his BP in the presence of CHF. His heart is pooping out, his pacemaker is keeping his HR controlled but not his cardiac output/BP.

Recently, I've been apart of some active shooter drills and MCI drills with SWAT medics. The tactic currently in use, at least in my experience, is team members initiate a sweep ignoring victims except a quick search for weapons, then a secondary team comes through to check the victims, stabilize with tourniquets etc and evacuate to the green zone. Rarely did the care they provided need the skills of a medic, but having the skills to rapidly triage in the thick of it is not something every medic has the skill to do.

I miss Dust

That's no different than any ER, FD, PD, EMS station across the country. There will always be those who are at work to find their next f*&S% buddy.